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Blood transfusion after cardiac surgery: is it the patient or the transfusion that carries the risk?

Dardashti, Alain LU ; Ederoth, Per LU ; Algotsson, Lars LU ; Brondén, Björn LU ; Lührs, Carsten and Bjursten, Henrik LU (2011) In Acta Anaesthesiologica Scandinavica 55. p.952-961
Abstract
Background: The transfusion of red blood cells (RBCs) after cardiac surgery has been associated with increased long-term mortality. This study reexamines this hypothesis by including pre-operative hemoglobin (Hb) levels and renal function in the analysis. Methods: A retrospective single-center study was performed including 5261 coronary artery bypass grafting (CABG) patients in a Cox proportional hazard survival analysis. Patients with more than eight RBC transfusions, early death (7 days), and emergent cases were excluded. Patients were followed for 7.5 years. Previously known risk factors were entered into the analysis together with pre-operative Hb and estimated glomerular filtration rate (eGFR). In addition, subgroups were formed based... (More)
Background: The transfusion of red blood cells (RBCs) after cardiac surgery has been associated with increased long-term mortality. This study reexamines this hypothesis by including pre-operative hemoglobin (Hb) levels and renal function in the analysis. Methods: A retrospective single-center study was performed including 5261 coronary artery bypass grafting (CABG) patients in a Cox proportional hazard survival analysis. Patients with more than eight RBC transfusions, early death (7 days), and emergent cases were excluded. Patients were followed for 7.5 years. Previously known risk factors were entered into the analysis together with pre-operative Hb and estimated glomerular filtration rate (eGFR). In addition, subgroups were formed based on the patients' pre-operative renal function and Hb levels. Results: When classical risk factors were entered into the analysis, transfusion of RBCs was associated with reduced long-term survival. When pre-operative eGFR and Hb was entered into the analysis, however, transfusion of RBCs did not affect survival significantly. In the subgroups, transfusion of RBCs did not have any effect on long-term survival. Conclusions: When pre-operative Hb levels and renal function are taken into account, moderate transfusions of RBC after CABG surgery do not seem to be associated with reduced long-term survival. (Less)
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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Anaesthesiologica Scandinavica
volume
55
pages
952 - 961
publisher
Wiley-Blackwell
external identifiers
  • wos:000294356500007
  • pmid:21574966
  • scopus:80052287317
ISSN
0001-5172
DOI
10.1111/j.1399-6576.2011.02445.x
language
English
LU publication?
yes
id
7a883c58-5be9-441f-8918-8a60a2b7b284 (old id 1972539)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21574966?dopt=Abstract
date added to LUP
2016-04-04 08:33:15
date last changed
2022-01-29 03:32:17
@article{7a883c58-5be9-441f-8918-8a60a2b7b284,
  abstract     = {{Background: The transfusion of red blood cells (RBCs) after cardiac surgery has been associated with increased long-term mortality. This study reexamines this hypothesis by including pre-operative hemoglobin (Hb) levels and renal function in the analysis. Methods: A retrospective single-center study was performed including 5261 coronary artery bypass grafting (CABG) patients in a Cox proportional hazard survival analysis. Patients with more than eight RBC transfusions, early death (7 days), and emergent cases were excluded. Patients were followed for 7.5 years. Previously known risk factors were entered into the analysis together with pre-operative Hb and estimated glomerular filtration rate (eGFR). In addition, subgroups were formed based on the patients' pre-operative renal function and Hb levels. Results: When classical risk factors were entered into the analysis, transfusion of RBCs was associated with reduced long-term survival. When pre-operative eGFR and Hb was entered into the analysis, however, transfusion of RBCs did not affect survival significantly. In the subgroups, transfusion of RBCs did not have any effect on long-term survival. Conclusions: When pre-operative Hb levels and renal function are taken into account, moderate transfusions of RBC after CABG surgery do not seem to be associated with reduced long-term survival.}},
  author       = {{Dardashti, Alain and Ederoth, Per and Algotsson, Lars and Brondén, Björn and Lührs, Carsten and Bjursten, Henrik}},
  issn         = {{0001-5172}},
  language     = {{eng}},
  pages        = {{952--961}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Acta Anaesthesiologica Scandinavica}},
  title        = {{Blood transfusion after cardiac surgery: is it the patient or the transfusion that carries the risk?}},
  url          = {{http://dx.doi.org/10.1111/j.1399-6576.2011.02445.x}},
  doi          = {{10.1111/j.1399-6576.2011.02445.x}},
  volume       = {{55}},
  year         = {{2011}},
}